Can Digital Mental Health Tools Save Psychology?

After decades of research on mental health treatments for conditions ranging from schizophrenia to depression, from anxiety to autism, our track record remains poor. For example, anxiety disorders alone will affect over 90 million people in the lifetime – in the U.S. alone. That’s approaching a third of our population. Yet, only a small fraction of us receive effective, long-lasting treatment. Thus, while we mental health professionals do much good and have some excellent, evidence-based treatments, we also know that, on balance, we are far from doing enough. We are failing.

I believe that there are many reasons for this failure. Psychological disorders are incredibly complex, with diverse and wide-ranging causes and manifestations that vary extremely from person to person. So we have an unbelievably tough problem to solve. But in addition, I believe that there is a two-part “recipe for disaster” that has put up additional barriers to the development of effective treatments:

The stigma of mental illness

Professionals minimize the importance of making treatments acceptable to the individual

The Stigma of Mental Illness

If you type “stigma definition” into Google, here is what comes up:

noun: stigma; plural noun: stigmata; plural noun: stigmas

a mark of disgrace associated with a particular circumstance, quality, or person.

It is no coincidence that mental illness is the paradigmatic example given by the dictionary. It is one of the most pervasive and persistent of the social stigmas. If we think about other sources of stigma – like the stigma suffered by those diagnosed with HIV/AIDS in the 80’s and 90’s and beyond – the stigma of mental illness is especially striking because mental illness is not contagious. But we fear it as if it were. The mentally ill are NOT more likely to commit violence, and yet, this is what many people fear. Take the media frenzy following the Sandy Hook Elementary School tragedy as an example of this type of assumption.

As long as mental illness remains a sign of disgrace and dishonor, people will avoid seeking professional help because it makes them feel broken – perhaps beyond repair.

Professionals Minimize the Importance of Making Treatments Acceptable to the Individual

There is another issue exacerbating the barrier represented by the stigma of mental illness. This barrier is that we scientists and practitioners, in our education, are socialized away from figuring out how to provide individuals with services they need in a way that they want – something that is obvious to any product- or service-oriented industry. Instead, we are taught to believe that we know best because we use the tools of science to develop the most efficacious treatments. The implicit narrative is: “We are the experts! We have figured out the best “medicine” for you, now take it!” This arrogance often keeps us from seeing that if we develop treatments that are too onerous or if treatments are embedded in a culture of disgrace and stigma, then we have failed to solve the problem. We have failed to meet “consumer needs.”

This is of course an overstatement and many mental health professionals actively fight against these attitudes. But there is a grain of truth here. Anyone on either side of the mental health fence – both professionals and patients – is familiar with this feeling, whether it’s acknowledged or swept under the rug.

How Digital Mental Health Tools Can Disrupt Stigma and Increase Acceptability of Treatments

In addition to breaking down barriers to effective, affordable, and accessible mental health treatment, I believe that digital – in particular mobile – mental health tools can be harnessed to have profound and lasting disruptive effects on the stigma of mental illness and on our failure to make acceptability of treatments a top priority. Here are five ways I believe digital mental health tools might just save Psychology:

If treatments are administered on a device, they are normalized

If we are successful in attempts to embed evidence-based treatments into mobile and gamified formats, I believe we can profoundly reduce the experience of and appearance of stigma. Devices have become our filters of information, our gateways to the world, sources of fun, and our hubs of connection. The actions we perform on our devices, by association, feel more “normal,” more connected to every aspect of our lives and to others. This creates a process of validation rather than shaming. By putting mental health treatments on devices, we might just be normalizing these treatments and creating positive emotional contagion – treatments become “good” by association with the devices we love. And if we gamify interventions, these effects could be strengthened even further.

Self-curating our mental health

With digital mental health tools, accessibility is exponentially increased. For example, with mobile mental health apps, you have affordable help “in the palm of your hand.” This ability to curate creates a sense of empowerment. This is “self-help” in a very real sense. With this high level of accessibility and empowerment, many of us will avail ourselves of interventions to reduce negative experiences and states. In addition, with the proliferation of digital tools to PROMOTE positive outcomes and to reach our fullest potential, we may find on the societal level that this positive focus is just as helpful – if not more so – as the focus on preventing negative outcomes. This attitude of promoting the positive is an excellent antidote to stigma. Who couldn’t benefit from promoting more of what is positive about oneself and how one lives life?

Digital health technology provides powerful platforms for community building

This is readily apparent. With greater community building comes a sense of belonging and a reduction of isolation. But digital community building also provides opportunities for effective advocacy. Of course, many such groups exist, but excellent digital mental health tools with a social media component could accelerate the creation of such systems, leveraging all the power of an individual’s full social network.

The profit motive will fuel innovation and valuing of consumer perspectives

Once interventions enter the digital and mobile technology world, the accompanying consumer focus (read $$$) will force the development of consumer-oriented products. Users have power in this domain. So, if interventions are onerous, boring, or non-intuitive, people will simply not use them. User stats will do the rest – no one will put resources into a product that people won’t use. Better ones WILL be developed.

Digital mental health increases opportunities for gamification

The gamification of mental health is beginning. At this point, we are taking baby steps, since we have an absence of a strong empirical base; in other words, there is precious little research showing that computerized games have a direct, positive influence on mental illness or on the promotion of mental wellness. But we are only in the earliest, exciting stages of this revolution. As I’ve written elsewhere, I don’t think all treatments should be computerized or gamified, nor do I think face-to-face therapy is obsolete – far from it. But I believe that if fun can be combined with powerful treatment technologies, then we can in a single step make profound progress in erasing the stigma of mental illness and creating treatments that people will truly want to use.

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14 thoughts on “Can Digital Mental Health Tools Save Psychology?”

Reblogged this on Big Red Carpet Nursing and commented:
Interesting times we live in. I worry about hype exceeding help with these products, although they may well do much good. What do you think of these new tools?

Thanks for the reblog! It is definitely a risk – the hype exceeding what these tools can actually deliver. That is why we need to devote a lot of energy and resources to doing excellent scientific research studying whether these tools actually work – like any other treatment modality. And if these tools don’t work, we need to make consumers aware. Eventually, these tools will be FDA-approved, and this will offer a much-needed level of protection.

I loved reading this blog. I have had so many years of being told different things by many different doctors. As a patient who has had bipolar 2 disorder for 8 years and just recently got the “right” diagnosis, if you can say there is a right one.

I have been told I need to be on all these very very toxic and scary drugs to cure what I have. Up until last winter I went along with it as my depressions were so bad I couldn’t really think for myself inturn making me very susceptible to believing anything anyone would tell me. After a near “close call” in the winter of potentially not being with this beautiful world anymore I decided to learn as much as I Could about this nasty disease and learn what I can do without all the prescription drugs to help me get better.

Reading blogs like this gives me hope. So thank you for this post.

If you are interested a cool doctor/page to look at that I also have found super helpful with any patient or person who has a mental illness is :

Reblogged this on dori5011's Blog and commented:
This is an amazing insight into mental illness, and I really truly believe people with mental illness can get better without all these nasty toxic drugs we are told we need 🙂
Thank you for this amazing post,
Dori ❤

Thank you! I’m glad you enjoyed the post. We are in such a stuck place in the mental health field – It’s hard to know what the right choices are. I’m not against medication for mental illness per se – I think for some people, it’s literally a life saver and one that let’s them benefit from other types of treatment all the more. But for so many, the effects of the drugs are almost worse than the disease.

It’s not just the normalisation that mobile devices provide, there’s a potential for anonoymity – there’s a relationship between you and an impersonal device rather than having to admit to something to another human, that may cause stigma. There’s also an anonymising effect of using a multi-function device. Look at the rise of certain e-books that people are reading on their commute that they would otherwise feel ashamed by. Reading such books on a device means that there is no external sign that the user would fear stigmatising them. As far as other commuters are concerned, there’s no difference between you reading “Overcoming Depression”, “Harry Potter” or today’s paper.

Being authentic is another matter. The first step is making sure the help is available and accessible. Tackling the stigma is a longer struggle, and not everyone will be comfortable opening up about it, so cater for everyone, and provide opportunities for those who are willing and able to speak out to help others. Not everyone wants to be an ambassador.